Electrophysiologic characteristics and radiofrequency catheter ablation in atrioventricular node reentrant tachycardia with second-degree atrioventricular block

Shih Huang Lee, Shih Ann Chen, Ching Tai Tai, Chern En Chiang, Zu Chi Wen, Kwo Chang Ueng, Chuen Wang Chiou, Yi Jen Chen, Wen Chung Yu, Jin Long Huang, Jun Jack Cheng, Mau Song Chang

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Introduction: Detailed electrophysiologic study of AV nodal reentrant tachycardia (AVNRT) with 2:1 AV block has been limited. Methods and Results: Six hundred nine consecutive patients with AVNRT underwent electrophysiologic study and radiofrequency catheter ablation of the slow pathway. Twenty-six patients with 2:1 AV block during AVNRT were designated as group I, and those without this particular finding were designated as group II. The major findings of the present study were: (1) group I patients had better anterograde and retrograde AV nodal function, shorter tachycardia cycle length (during tachycardia with 1:1 conduction) (307 ± 30 vs 360 ± 58 msec, P <0.001), and higher incidence of transient bundle branch block during tachycardia (18/26 vs 43/609, P <0.001) than group II patients; (2) 21 (80.8%) group I patients had alternans of AA intervals during AVNRT with 2:1 AV block. Longer AH intervals (264 ± 26 vs 253 ± 27 msec, P = 0.031) were associated with the blocked beats. However, similar HA intervals (51 ± 12 vs 50 ± 12 msec, P = 0.363) and similar HV intervals (53 ± 11 vs 52 ± 12, P = 0.834) were found in the blocked and conducted beats; (3) ventricular extrastimulation before or during the His-bundle refractory period bundle could convert 2:1 AV block to 1:1 AV conduction. Conclusions: Fast reentrant circuit, rather than underlying impaired conduction of the distal AV node or infranodal area, might account for second-degree AV block during AVNRT. Slow pathway ablation is safe and effective in patients who have AVNRT with 2:1 AV block.

Original languageEnglish
Pages (from-to)502-511
Number of pages10
JournalJournal of Cardiovascular Electrophysiology
Volume8
Issue number5
Publication statusPublished - 1997
Externally publishedYes

Fingerprint

Atrioventricular Nodal Reentry Tachycardia
Atrioventricular Node
Catheter Ablation
Atrioventricular Block
Tachycardia
Bundle of His
Bundle-Branch Block
Incidence

Keywords

  • atrioventricular block
  • atrioventricular nodal reentrant tachycardia
  • catheter ablation
  • electrophysiologic study
  • radiofrequency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Electrophysiologic characteristics and radiofrequency catheter ablation in atrioventricular node reentrant tachycardia with second-degree atrioventricular block. / Lee, Shih Huang; Chen, Shih Ann; Tai, Ching Tai; Chiang, Chern En; Wen, Zu Chi; Ueng, Kwo Chang; Chiou, Chuen Wang; Chen, Yi Jen; Yu, Wen Chung; Huang, Jin Long; Cheng, Jun Jack; Chang, Mau Song.

In: Journal of Cardiovascular Electrophysiology, Vol. 8, No. 5, 1997, p. 502-511.

Research output: Contribution to journalArticle

Lee, SH, Chen, SA, Tai, CT, Chiang, CE, Wen, ZC, Ueng, KC, Chiou, CW, Chen, YJ, Yu, WC, Huang, JL, Cheng, JJ & Chang, MS 1997, 'Electrophysiologic characteristics and radiofrequency catheter ablation in atrioventricular node reentrant tachycardia with second-degree atrioventricular block', Journal of Cardiovascular Electrophysiology, vol. 8, no. 5, pp. 502-511.
Lee, Shih Huang ; Chen, Shih Ann ; Tai, Ching Tai ; Chiang, Chern En ; Wen, Zu Chi ; Ueng, Kwo Chang ; Chiou, Chuen Wang ; Chen, Yi Jen ; Yu, Wen Chung ; Huang, Jin Long ; Cheng, Jun Jack ; Chang, Mau Song. / Electrophysiologic characteristics and radiofrequency catheter ablation in atrioventricular node reentrant tachycardia with second-degree atrioventricular block. In: Journal of Cardiovascular Electrophysiology. 1997 ; Vol. 8, No. 5. pp. 502-511.
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abstract = "Introduction: Detailed electrophysiologic study of AV nodal reentrant tachycardia (AVNRT) with 2:1 AV block has been limited. Methods and Results: Six hundred nine consecutive patients with AVNRT underwent electrophysiologic study and radiofrequency catheter ablation of the slow pathway. Twenty-six patients with 2:1 AV block during AVNRT were designated as group I, and those without this particular finding were designated as group II. The major findings of the present study were: (1) group I patients had better anterograde and retrograde AV nodal function, shorter tachycardia cycle length (during tachycardia with 1:1 conduction) (307 ± 30 vs 360 ± 58 msec, P <0.001), and higher incidence of transient bundle branch block during tachycardia (18/26 vs 43/609, P <0.001) than group II patients; (2) 21 (80.8{\%}) group I patients had alternans of AA intervals during AVNRT with 2:1 AV block. Longer AH intervals (264 ± 26 vs 253 ± 27 msec, P = 0.031) were associated with the blocked beats. However, similar HA intervals (51 ± 12 vs 50 ± 12 msec, P = 0.363) and similar HV intervals (53 ± 11 vs 52 ± 12, P = 0.834) were found in the blocked and conducted beats; (3) ventricular extrastimulation before or during the His-bundle refractory period bundle could convert 2:1 AV block to 1:1 AV conduction. Conclusions: Fast reentrant circuit, rather than underlying impaired conduction of the distal AV node or infranodal area, might account for second-degree AV block during AVNRT. Slow pathway ablation is safe and effective in patients who have AVNRT with 2:1 AV block.",
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T1 - Electrophysiologic characteristics and radiofrequency catheter ablation in atrioventricular node reentrant tachycardia with second-degree atrioventricular block

AU - Lee, Shih Huang

AU - Chen, Shih Ann

AU - Tai, Ching Tai

AU - Chiang, Chern En

AU - Wen, Zu Chi

AU - Ueng, Kwo Chang

AU - Chiou, Chuen Wang

AU - Chen, Yi Jen

AU - Yu, Wen Chung

AU - Huang, Jin Long

AU - Cheng, Jun Jack

AU - Chang, Mau Song

PY - 1997

Y1 - 1997

N2 - Introduction: Detailed electrophysiologic study of AV nodal reentrant tachycardia (AVNRT) with 2:1 AV block has been limited. Methods and Results: Six hundred nine consecutive patients with AVNRT underwent electrophysiologic study and radiofrequency catheter ablation of the slow pathway. Twenty-six patients with 2:1 AV block during AVNRT were designated as group I, and those without this particular finding were designated as group II. The major findings of the present study were: (1) group I patients had better anterograde and retrograde AV nodal function, shorter tachycardia cycle length (during tachycardia with 1:1 conduction) (307 ± 30 vs 360 ± 58 msec, P <0.001), and higher incidence of transient bundle branch block during tachycardia (18/26 vs 43/609, P <0.001) than group II patients; (2) 21 (80.8%) group I patients had alternans of AA intervals during AVNRT with 2:1 AV block. Longer AH intervals (264 ± 26 vs 253 ± 27 msec, P = 0.031) were associated with the blocked beats. However, similar HA intervals (51 ± 12 vs 50 ± 12 msec, P = 0.363) and similar HV intervals (53 ± 11 vs 52 ± 12, P = 0.834) were found in the blocked and conducted beats; (3) ventricular extrastimulation before or during the His-bundle refractory period bundle could convert 2:1 AV block to 1:1 AV conduction. Conclusions: Fast reentrant circuit, rather than underlying impaired conduction of the distal AV node or infranodal area, might account for second-degree AV block during AVNRT. Slow pathway ablation is safe and effective in patients who have AVNRT with 2:1 AV block.

AB - Introduction: Detailed electrophysiologic study of AV nodal reentrant tachycardia (AVNRT) with 2:1 AV block has been limited. Methods and Results: Six hundred nine consecutive patients with AVNRT underwent electrophysiologic study and radiofrequency catheter ablation of the slow pathway. Twenty-six patients with 2:1 AV block during AVNRT were designated as group I, and those without this particular finding were designated as group II. The major findings of the present study were: (1) group I patients had better anterograde and retrograde AV nodal function, shorter tachycardia cycle length (during tachycardia with 1:1 conduction) (307 ± 30 vs 360 ± 58 msec, P <0.001), and higher incidence of transient bundle branch block during tachycardia (18/26 vs 43/609, P <0.001) than group II patients; (2) 21 (80.8%) group I patients had alternans of AA intervals during AVNRT with 2:1 AV block. Longer AH intervals (264 ± 26 vs 253 ± 27 msec, P = 0.031) were associated with the blocked beats. However, similar HA intervals (51 ± 12 vs 50 ± 12 msec, P = 0.363) and similar HV intervals (53 ± 11 vs 52 ± 12, P = 0.834) were found in the blocked and conducted beats; (3) ventricular extrastimulation before or during the His-bundle refractory period bundle could convert 2:1 AV block to 1:1 AV conduction. Conclusions: Fast reentrant circuit, rather than underlying impaired conduction of the distal AV node or infranodal area, might account for second-degree AV block during AVNRT. Slow pathway ablation is safe and effective in patients who have AVNRT with 2:1 AV block.

KW - atrioventricular block

KW - atrioventricular nodal reentrant tachycardia

KW - catheter ablation

KW - electrophysiologic study

KW - radiofrequency

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